The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) characterizes enuresis as a disorder when there is a persistent loss of bladder control after age 5 years.
There are 2 categories of enuresis: Monosymptomatic enuresis (MNE) – Does not include bladder dysfunction during daytime. Nonmonosymptomatic enuresis (NMNE) – Includes bladder dysfunction causing daytime incontinence that is frequent and urgent.
Psychological or emotional problems: Emotional stress caused by traumatic events or disruptions in a child's normal routine can cause bedwetting. For example, moving to a new home, enrolling in a new school, or the death of a loved one may cause bedwetting episodes that become less frequent over time.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), classified both enuresis and encopresis under the heading of elimination disorders. DSM-5 criteria for enuresis are as follows: Repeated voiding of urine into bed or clothes, whether involuntary or intentional.
Studies support the link between enuresis and ADHD where an association between higher scores of ADHD in children having enuresis problems specially inattention [7, 8]. On the other hand, children with ADHD have a higher incidence of enuresis [9].
Patients with ADHD have higher incidence of enuresis. Poor completion rates of traditional bedwetting calendars in children with ADHD have been observed. A daily computerised interactive behavioural modification therapy can help in treating enuresis in children with ADHD and comorbid enuresis disorder.
Someone with primary nocturnal enuresis has wet the bed since he or she was a baby. This is the most common type of enuresis. Secondary enuresis is a condition that develops at least 6 months — or even several years — after a person has learned to control their bladder.
Most children outgrow bed-wetting on their own — but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention. Consult your child's doctor if: Your child still wets the bed after age 7.
You're likely to start by seeing your child's pediatrician. However, he or she may refer you to a doctor who specializes in urinary disorders (pediatric urologist or pediatric nephrologist).
Behavior therapy with a urine alarm is the treatment of choice for simple bed-wetting. Over 50 years of research supports this claim. A permanent solution to bed-wetting can be expected for about 5 of every 10 children treated with a urine alarm.
Stress and anxiety in and of themselves will not cause a child who never wet the bed to start nighttime wetting. However, stress can contribute indirectly to nighttime wetting. Emotional and psychological stress can cause a child to behave or act differently, which can lead to nighttime wetting.
And although stress can indirectly affect a child's bedwetting, most experts believe it isn't the reason a child starts wetting the bed. There's just “no major association between anxiety, stress, and bedwetting,” says Anthony Atala, MD, chair of urology at the Wake Forest University School of Medicine.
Primary enuresis is present if the child has never been dry for at least six months. Secondary enuresis is diagnosed if a child starts wetting the bed again after having been dry for at least six months.
Bedwetting and Bladder Issues
“Every child is different. But as a general rule, if your son or daughter is not dry through the night by age six, you may want to have a consultation with a pediatric urologist,” Dr. Hannick says.
Primary nocturnal enuresis almost always resolves spontaneously over time. Treatment should be delayed until the child is able and willing to adhere to the treatment program; medications are rarely indicated in children younger than seven years. If the condition is not distressing to the child, treatment is not needed.
Bedwetting often runs in families: many kids who wet the bed have a relative who did too. If both parents wet the bed when they were young, it's very likely that their child will.
Most children with primary nocturnal enuresis have significant signs of stress and mental problems and most of the symptoms are anxiety disorders (10-12). Logan et al. (13) (2014) showed that 60% of patients with enuresis disorder had at least one mental factor.
There is more evidence suggesting that enuresis is the result of a developmental delay in the normal process of achieving nighttime control. The normal process involves the release of a hormone that prompts the kidneys to slow down production of urine during nighttime sleep.
It's actually a fairly common problem for kids with ADHD. They're about three times as likely to have bedwetting trouble than other kids. It's not totally clear why. Some researchers think it's because bedwetting and ADHD are both linked to a delay in the development of the central nervous system.
Bedwetting is also called sleep enuresis. It is a parasomnia. A parasomnia involves undesired events that come along with sleep. Bedwetting occurs when a person urinates by accident in his or her sleep.
Drug classes that induce urinary incontinence include α1-adrenoceptor antagonists, antihypertensives, antipsychotics, benzodiazepines, antidepressants hormone replacement therapy, and antiepileptics.
Conversely, children who are depressed sometimes show up with symptoms common in childhood like enuresis or bed-wetting -- that's a common symptom of depression in young people.
It turns out that incontinence is quite common in people suffering from PTSD, regardless of their age. You don't even have to be a vet – if you have PTSD from witnessing or experiencing some other traumatic incident in your life, you're at high risk of developing urinary leakage.